Institutional and structural forms of HIV-related discrimination in health care : a study set in Beijing

This paper presents key findings of a situational analysis of institutional and structural levels of HIV/AIDS-related discrimination in Beijing, China, with a focus on the area of health care. Initially slow to respond to the presence of HIV, China has altered its approach and enacted strict legislative protection for people living with HIV/AIDS (PLWHA). In order to determine whether this has altered discrimination against PLWHA, this study examined existing legislation and policy, and interviewed key informants working in health care and PLWHA. The overall findings revealed that discrimination in its many forms continued to occur in practice despite China's generally strong legislative protection, and it is the actual practice that is hindering PLWHAs' access to health services. A number of legislative and policy gaps that allow discrimination to occur in practice were also identified and discussed. The paper concludes with a call to rectify specific gaps between legislation, policy and practice. An understanding of the underlying factors that drive discrimination will also be necessary for effective strategic interventions to be developed and implemented.

An Asia Pacific six-country study on HIV-related discrimination : introduction

This paper outlines a six-country study of institutionalised forms of HIV/AIDS-related discrimination in the Asia-Pacific region. Although recognised as a barrier to disease prevention and treatment, very limited data are available on the effects of institutionalised HIV-related stigma and discrimination. Understanding the forms of discrimination within the institutions where they occur is the first step to identifying effective ways of promoting compassionate, non-discriminatory treatment of PLWHA. Thus, the goal of this research project was to document institutional discrimination against PLWHA, as guided by the UNAIDS Protocol for the Identification of Discrimination Against People Living with HIV (2000), in six Asian countries: India, Thailand, Philippines, China, Vietnam and Indonesia. As a precursor to the six individual studies, this paper provides a brief overview of the literature on HIV discrimination, and then describes the UNAIDS Protocol and the shared methodological considerations relevant to all of the study sites. Commonalities in sampling, procedures and analysis are also discussed.

Evidence-based public health: what does it offer developing countries?

The global burden of disease and illness is primarily situated in developing countries. As developing countries have limited resources, it is particularly important to invest in public health and health promotion strategies that are effective. Systematic reviews are central to evidence-based public health and health promotion practice and policy. This paper discusses issues surrounding the relevance of evidence-based public health and systematic reviews to the health of developing countries. It argues that there is a lack of systematic reviews relevant to the health priorities of developing countries; many interventions reviewed can not be implemented in resource-poor situations; and, a limited amount of primary research is conducted in developing countries. The paper further argues that improvements in public health are determined not only by effective health services and interventions, but through an approach that includes other sectors and influences broader structural and systematic barriers to health. Given the social complexity of human development, and the inter-sections amongst different development goals, there is no question that gains in developing country public health are unlikely to emerge from systematic reviews alone, but will require decisions about inter-sectoral collaboration and social policy initiatives. Nonetheless, evidence around intervention effectiveness has an important role to play in addressing health priorities in developing countries and resource-poor areas. The public health evidence base urgently needs strengthening, with dedicated effort towards increasing the relevance of primary evidence and systematic reviews.

Australian law students' perceptions of their values: interim results in the first year--2001--of a three--year empirical assessment

This study attempts to answer an essential social policy question: what values are characteristic of the mass of Australian lawyers' in their last year of law school and their early careers, and how do these values develop or degrade over time? This question is important because of the concern felt in the community as to the activities of lawyers. In recent years the Australian legal profession has sustained more scrutiny by governments, regulators and consumer movements than in any previous period of our history. The perception that practitioners' competencies and ethics are deficient and materially linked both to reduced standards of performance and to higher levels of public complaints, has received attention from academics, law societies, parliamentary committees and the Australian Competition and Consumer Commission.

East Timor : beyond independence

The chapters in this book examine the major themes of development, borders and security, politics and justice, resource and land management, education, and language policy. Though the country was initially lauded as a case study in successful state-building, the crisis of 2006 demonstrated that East Timor had more in common with other post-colonial, post-conflict societies than some of thse earlier optimistic assessments suggested. East Timor continues to attract the interest and attention of governments, scholars, development institutions and aid workers as a society rebuilding itself after almost a quarter of a century of profound trauma, and the consecutive eras of colonialism. Covering the era from the independence referendum in August 1999 to the political crisis in 2006, and future prospects and challenges, this book is an invaluable resource for understanding the challenges facing the first new nation of the 21st century.

John Howard, Australian conservative

John Howard was the first elected Australian prime minister to identify himself as a conservative; he claimed to be a liberal in economic policy and a conservative in social policy.

Community water fluoridation : is it still worthwhile

Community Water Fluoridation (CWF) is the adjustment of fluoride concentration in community drinking water to a level that confers optimal protection from dental caries (Truman et al 2002). It is supported by many authorities as the single most effective public health measure for reducing dental caries (DHS 2007). It has consistently been shown to be effective in reducing the prevalence and severity of dental caries in populations following its introduction (NHMRC 1999). The most dramatic reductions (50-60%) were demonstrated in the earlier studies although more recent research has still shown reductions of between 30 and 50% (Truman et al 2002). Despite the strong scientific evidence for its beneficial effects and safety the issue of the appropriateness of CWF is often the focus of public debate. Proponents argue that it reduces dental caries. is safe and cost effective. and that it provides significant benefits to all social classes (Slade et al 1995: Slade et a 1996: Spencer et al 1996). Opponents question its efficacy and safety and argue that its addition to community water supplies is unethical mass medication (Colquhoun 1990: Diesendorf 1986: Diesendorf et al 1997).

More recently, however, there have been important questions raised regarding the continuing benefit of CWF over and above that produced by the widespread use of other sources of fluoride (toothpaste. mouth rinses. varnish and other professionally applied fluorides). Generally, dental caries has declined steeply in the last thirty years and many have observed that dental caries has also reduced in parts of Australia and other countries where there has never been CWF or where it has ceased. It has been suggested that because of the current low population levels of dental caries and the increase in alternate sources of fluoride, CWF no longer offers the benefits it may have in the past. Given this notion, together with the concerns of a minority subgroup of the population regarding the safety of CWF, it is valuable to examine current evidence to answer the question: Is there still a role for CWF in Australia?

This paper will firstly examine the history of water fluoridation and its mechanisms of action. Secondly. trends in dental decay experience over the last three decades with particular emphasis on social and geographical inequities in Australia will be described. We also review the current state of scientific evidence for the benefits of CWF including the contribution it makes to the reduction of oral health inequalities. In light of this we will provide a response to the question posed above.

Wait no more : the use of private dental services by welfare recipients in Australia

Dental services in Australia are available both privately and publicly. However, access to public dental services, like access to public hospital services for non-urgent treatment, is subject to a considerable waiting period. Moreover, access to public dental services is restricted to certain categories of welfare beneficiaries who qualify for a health care card. Because of the waiting time for public treatment, there is a frequent call for more public dental resources. This paper addresses the issue of what the waiting time for public dental services represents. One view largely confirmed by our research is that state governments are using the waiting time as a way of trying to push more and more people into the private sector. We find that more and more health care card holders are using the
private sector for dental services.

Theorising men's violence towards women in refugee families : towards in intersectional feminist framework

Violence against women perpetrated by male partners, or ex-partners. is one of the most concerning and prevalent public health issues in the world today and is a major cause of injury and mental illness among women and children. Violence against women occurs in most societies irrespective of culture, socio-economic status or religion. Nevertheless, it has been identified that immigrant and refugee women are particularly at risk in cases of domestic violence (Easteal 1996: Narayan 1997; Human Rights Watch 2000; Walter 2001: Perilla 2003: Kang Kahler & Tesar 2003:). To make sense of this issue. we articulate an intersectional feminist framework that we used to analyse the results of an empirical investigation of men's violence against women in refugee families in Melbourne. II)

Although this research has investigated the complex field of domestic violence, culture. trauma and historical and contemporary disadvantage, it has a fundamental prerequisite standing that regardless of past and current experiences; men must take responsibility for their violence against women. Our concern is to understand how male domination manifests itself within each culture and emerging, changing cultures in the diaspora, to explore the connections with men's violence against women within the unique domain of the refugee experience.

Building collaborative partnerships: a key to increasing Indigenous Victorian peoples' access to country

This article reports on a qualitative research study undertaken with Indigenous government employees to explore ways in which Indigenous communities can access programs involving caring for Country' (knowledge, responsibility and inherent right to protect the traditional natural landscape) on their traditional land and, in so doing. improve their health. Factors that optimise such nature-based projects are the capacity of their intention to build relationships, consultation. transparency, consistency, education and training between Indigenous communities. government and the general public. Government agencies need to develop strategies where partnership and collaboration are effective with Indigenous communities and within the agencies themselves, in order to resolve controversial issues surrounding access to Country.

Western Australia intercultural arts research project : an investigation into culturally and linguistically diverse art and artists in Western Australia

Background: The introduction of the Australia Council's 'Arts in a Multicultural Australia Policy' (AIMAP) (2000) represented a shift in how the arts in multicultural communities were viewed. It has long been recognised that the arts play a significant role in promoting social cohesion, social policy goals, economic growth, and shaping a nation’s sense of identity. However, prior to the introduction of this policy, multicultural arts was typically seen as involving cultural retentive activities which had their roots in expressions of migrant cultural traditions. The introduction of the policy heralded the beginning of an era in which culturally and linguistically diverse (CaLD) Australians were seen as integral to the fabric of the Australian arts sector. Evaluation of the policy in 2005 however, revealed that culturally and linguistically diverse Australians were under-represented in most artistic categories. Western Australia is the most culturally diverse state in Australia. It is therefore of great interest to the State Government to have a comprehensive picture of the situation in that state. Hence, the Office of Multicultural Interests (OMI) commissioned Deakin University to undertake an investigation into the participation rates of CaLD artists in the arts sector in Western Australia.

Scope: The project examined the participation in the arts of CaLD artists in Western Australia. The arts sector comprises many more individuals and organisations than artists. For example, there are arts agency administrators, venue operators, policy officers, curators, and countless others who work together to make up the arts sector. This project focused on the artists, the individuals such as those who make music, visual art, dance and theatre performances. In the past it has been shown that CaLD populations are not well represented in the broader arts sector. This research aimed to discover the current position for CaLD artists in terms of participation in the broader arts sector and what factors influence their situation.

Consumer participation in designing community based consumer-directed disability care : lessons from a participatory action research-inspired project

User participation has been embraced worldwide as a means to provide better consumer outcomes in health and community care. However, methodologies to achieve effective consumer engagement at the programme design level have remained under-explored. The purpose of this study was to evaluate the impact of a Participatory Action Research (PAR)-inspired methodology used to develop a consumer-directed community care/individualised funding service model for people with disabilities. A retrospective analysis of case notes and internal reports for the first 6 years of an ongoing project were examined. The findings suggest that PAR methodologies need to take into account community development, group support, and capacity building as well as succession planning and risk management issues in order to facilitate the often lengthy policy and project development process. Drawing on these findings, this article discusses five lessons and their methodological implications for PAR in a health or social policy/programme design context.